Effects of Conservative Treatment for Osteoporotic Thoracolumbal Spine Fractures
Adnana Talic, Jasmin Kapetanovic, Adnan Dizdar
Mat Soc Med. 2012; 24(1): 16-20
Introduction: Osteoporosis has a significant role in the etiology of thoracolumbal spinal fractures in older patients. It is the segment where the relatively immobile thoracic segment transfers into a mobile lumbar spine. The clinical picture is always with the back pain after minimal trauma or sometimes even without injury. Diagnosis always includes X-ray and then CAT scan. Treatment depends on the stability of the fracture, neurological findings, and the size of the deformity. Consequences include pain in the legs, back, spinal deformity, reduced lung function, walking disturbances, etc. Goal: In this paper we will present the patients who were treated by conservative approach for osteoporotic fractures in thoracolumbal spine. Material and methods: They were treated at the Clinic for Orthopedics and Traumatology of Clinical Center university of Sarajevo from December 1st until December 31st 2010. Patients were divided into two groups: group I consisted of patients who were treated with orthoses, and group II patients treated with plaster corset. Both treatments have their use. Results and discussion: Plaster corset gives stability; patients with orthoses are more mobile without skin changes. Orthosis is recommended for most disciplined patients and the best is that all the patients have plaster corset for six weeks, followed until the recovery by three points orthoses.
1. Kučukalić–Selimović E. i sar., Osteoporoza dijagnostika, prevencija, liječenje; Institut za naučnoistraživački rad i razvoj KCUS, 2008.
2. Komadina R. in sod. Zlami zaradi osteoporoze, Društvo traumatologa Slovenije, Celje, 1999.
3. Hadžiahmetović Z, Hadžiahmetović–Vavra N. Traumatologija, Avicena, Sarajevo, 2005.
4. Biščević M. Moderne tehnike liječenja osteoporotskih prijeloma kičme – vertebroplastika i kifoplastika, Univerziteti Tuzla i Sarajevo, 2011.
5. Buljat G, Perović D. Treatment of osteoporotic fractures of the spine Arh Hig Rada Toksikol. 2007; 58: 49-54.
6. Denis F. Spinal instability as defined by the three-column concept in acute spinal trauma. Clin Orthop. 1984; 189: 65-9.
7. Melton LJ, Kan SH, Frye MA, Wahner HW, O’Fallon WM, Riggs BL. Epidemiology of vertebral fractures in women. Am J Epidemiol. 1989 May; 129(5): 1000–1011.
8. Lonstein JE. History of spinal bracing. Orthotics 703, course for physicians and surgeons, Northwestern University Medical School, Prosthetic-Orthotic Center, 1989-1992.
9. Hančević J, Antoljak T, Korač Ž. Imobilizacija, Medicinska naklada, Zagreb, 2001.
10. Axelsson P, Johnsson R, Stromqvist B. Effect of lumbar orthosis on intervertebral mobility. A roentgen stereophotogrammetric analysis. Spine. 1992; 17: 678–681.
11. Anderson PA. Nonsurgical treatment of patients with thoracolumbar fractures. Instr Course Lect. 1995; 44: 57–65.
12. Cantor JB, Lebwohl NH, Garvey T, Eismont FJ. Nonoperative management of stable thoracolumbar burst fractures with early ambulation and bracing. Spine. 1993; 18: 971-976.
13. Chow GH, Nelson BJ, Gebhard JS, Brugman JL, Brown CW, Donaldson DH. Functional outcome of thoracolumbar burst fractures managed with hyperextension casting or bracing andearly mobilization. Spine. 1996; 21: 2170-2175.
14. Golubović Z, Stojiljković P, Bošnjaković P, Radovanović Z, Višnjić A, Ristić S, Golubović I, Najman S. Prelomi pršljenova kičmenog stuba kod bolesnika sa osteoporozom
15. Acta facultatis medicae Naissensis, 2008; 25(2): 69-74.
16. Grew ND, Deane G. The physical effect of lumbar spinal supports. Prosthet Orthot Int. 1982; 6: 79-87.
17. Haefeli M, Elfering A. Pain assessment. Eur Spine J. 2006; 15(Suppl1): S17–S24.
18. Willen J, Lindahl S, Nordwall A. Unstable thoracolumbarfractures. A comparative clinical study of conservative treatment and Harrington instrumentation. Spine. 1985; 10: 111-22.
19. Tonbul M, Yilmaz MR, Ozbaydar MU, Adaş M, Altan E. Long-term results of conservative treatment for thoracolumbar compression fractures Acta Orthop Traumatol Turc. 2008 Mar-Apr; 42(2): 80-3.